TIMOTHY MICHAEL KAMP Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****74

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

MICHAEL

Last Name

KAMP

Business Name

TIMOTHY MICHAEL KAMP

Original Issue Date

06/15/2017

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021